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Smoking May Make Psoriasis Worse
People with psoriasis are more likely
to be smokers, and the smoking habit appears to make the skin condition worse,
according to two new studies.
The finding "highlights the importance of smoking cessation in patients
with psoriasis," according to the Italian team that led one of the studies.
The second report found that people with psoriasis are also more likely to
be obese than people without the skin ailment.
Both studies appear in the December issue of the Archives of Dermatology.
In the first report, a team led by Cristina Fortes, from the Istituto di Ricovero
e Cura a Carattere Scientifico, in Rome, collected data on 818 patients who
had psoriasis.
The researchers found that patients who smoked more than a pack of cigarettes
a day had twice the risk of having more severe psoriasis, compared with patients
who smoked 10 cigarettes or less a day. They also found that psoriasis was
more severe among women who smoked than men who smoked.
In the second report, researchers found that people with psoriasis were more
likely to smoke and also more likely to be obese. However, patients tended
to start smoking and gain weight after they developed the condition, the researchers
reported.
"Psoriasis is a disease that does something to the psyche that causes
patients to care less about their appearance. Because they care less about
their appearance, they are more willing to partake in other risky behaviors," speculated
lead researcher Dr. Gerald G. Krueger, a professor of dermatology at the University
of Utah School of Medicine.
According to the National Institutes of Health, psoriasis is a chronic skin
disease of scaling and inflammation that affects 2 percent to 2.6 percent of
Americans, or between 5.8 million and 7.5 million people. It occurs when skin
cells quickly rise from their origin below the surface of the skin and pile
up on the surface before they have a chance to mature. Psoriasis typically
results in patches of thick, inflamed skin covered with silvery scales. They
most often occur on the elbows, knees, other parts of the legs, scalp, lower
back, face, palms, and soles of the feet.
Krueger and his colleagues originally thought that obesity was one of the
causes of psoriasis. "That's not the case," he said. "What happens
is that psoriasis develops and then obesity develops as a consequence."
In their study, the researchers looked at patients in the Utah Psoriasis Initiative
(UPI) and compared them with three other population databases and with 500
adult patients who did not have psoriasis.
They found that 34 percent of the patients in the UPI were obese, compared
with the 18 percent found in the general Utah population. Obesity was also
more common in psoriasis patients than in patients who didn't have psoriasis.
The researchers also found that 37 percent of the patients in the UPI smoked,
compared with 13 percent of patients in the general Utah population. Smoking
seemed to be a causal factor in psoriasis, but many patients also took up smoking
after they developed the condition, Krueger said.
"If you are not genetically predisposed to having psoriasis, one of the
things that you can do to make sure that you get psoriasis is smoke," Krueger
said.
The researchers aren't sure why psoriasis seems to be linked to obesity. "Do
people with psoriasis have a poor self-image or sit around more, or drink more
alcohol, or are depressed? We don't know," Krueger said.
The increase in smoking and obesity among people with psoriasis is creating
public health issues, Krueger said. "These issues are the same as what
are seen in the general population in those people who have increased body
mass and smoke," he said. "These include cardiovascular disease and
musculoskeletal problems."
Dr. Jeffrey M. Weinberg, the director of the clinical research center in the
department of dermatology at St. Luke's-Roosevelt Hospital Center, in New York
City, said the new findings will change his clinical practice.
"Having seen this data, warning patients not to smoke will become part
of my regular evaluation and counseling," he said. "Cessation and
avoidance of smoking should become a major lifestyle for our patients."
For more on psoriasis, visit the National
Psoriasis Foundation.
SOURCES: Gerald G. Krueger, M.D., professor, dermatology, University of Utah
School of Medicine, Salt Lake City; Jeffrey M. Weinberg, M.D., director, clinical
research center, department of dermatology, St. Luke's-Roosevelt Hospital Center,
New York City; December 2005 Archives of Dermatology
Reference
Source 62
December
22, 2005
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